Medical assessment for hair loss (Finasteride)

What happens during male pattern hair loss?

Hereditary hair loss, medically known as androgenetic alopecia, affects most men at some point in their lives. This process is driven by both genetics and hormones.

• Shrinking hair follicles: In male pattern baldness, hair follicles are genetically programmed to be hypersensitive to the hormone DHT. This causes the follicles to gradually shrink, producing thinner and shorter hair until they eventually stop producing hair altogether.
• Early intervention: The process typically begins at the hairline (receding temples) or the crown. The earlier you notice the signs, the better the chances of slowing down the progression, as it is far easier to preserve existing hair than to regrow what has already been lost.

How does Finasteride work?

Finasteride works by blocking the enzyme (5-alpha reductase) that converts testosterone into the hormone DHT.

By lowering the levels of DHT in the scalp, the hair follicles are protected from the negative influence that causes them to shrink. The primary goal of the treatment is to stop further hair loss and strengthen the hair you still have.

How we perform the assessment

To ensure a responsible medical evaluation, the initiation of hair loss treatment always requires a physical consultation.

• Physical examination requirement: A doctor must physically inspect the scalp to provide an accurate diagnosis and rule out other medical causes for hair loss.
• No prescriptions via video: We do not issue prescriptions for Finasteride via video consultations. This is for your safety, ensuring the doctor can perform a comprehensive clinical assessment in person.
• No guarantee of a prescription: A medical appointment is a professional consultation. There is no automatic guarantee that the appointment will result in a prescription; the doctor will always prioritize your overall health and assess whether the benefits outweigh the risks.

Which doctor should I book?

• Dermatologist (Recommended): Our dermatologists are specialists in skin, scalp, and hair disorders. They are the appropriate experts for a thorough initial assessment, especially if you are unsure of the cause of your hair loss or seek a specialist’s evaluation for "off-label" treatment.
• General Practitioner (GP): Can assist with an in-person consultation to evaluate your situation. The GP will always perform an independent assessment of the benefits versus the risks and provide clear professional guidance based on your health history before any treatment is initiated or continued.

Side effects and safety

As with all medications, Finasteride can cause side effects. While most people tolerate the medication well, it is important to be informed before starting treatment.

Common and known side effects may include:

• Decreased libido (sex drive).
• Erectile dysfunction.
• Reduced ejaculation volume.
• Tenderness or enlargement of breast tissue.
• Mood changes, such as depressive symptoms.

Side effects are often reversible and disappear if the medication is discontinued, though in rare cases, they may persist. This is a key reason why we require a physical consultation and ongoing dialogue with a physician.

Our prescribing guidelines

• 1 mg tablets only: We exclusively prescribe Finasteride in the 1 mg dosage, which is the international medical standard for the treatment of hair loss.
• No use of Proscar (5 mg): Our GPs do not prescribe 5 mg tablets (Proscar) to be split. Proscar is a medication intended for prostate conditions. By strictly using the 1 mg dose, we ensure correct dosage and your personal safety.
• Follow-up: The treatment must be used continuously to remain effective. We recommend scheduled follow-ups with the same doctor to monitor results and any potential side effects over time.

Why do doctors have different opinions?

You may find that different doctors assess Finasteride differently. This is due to:

Benefit vs. Risk: Doctors make individual professional judgments on whether the aesthetic benefit justifies the risk of potential side effects.

"Off-label" use: In Norway, Finasteride 1 mg is currently not marketed with hair loss as a registered indication in the official pharmaceutical product compendium (Felleskatalogen). When a doctor prescribes it for hair loss, it is considered "off-label." This places a specific professional responsibility on the physician, and it is therefore up to each individual doctor's discretion whether they feel comfortable prescribing it.

Ready for an assessment?